Developing in the lower legs, this
common eczema occurs when circulation becomes sluggish. Poor blood
flow causes fluids to build up, and the legs swell. Over time, this
build up of fluids affects the skin, causing a rash that usually
itches, painful sores, as well as thinning and discolored skin.
Effective treatment involves treating not only the dermatitis but
the circulatory problem as well.
Venous stasis dermatitis
Stasis dermatitis has
developed on this elderly man’s leg. He says the affected area
swells and itches sporadically.
with permission of the American Academy of
National Library of Dermatologic Teaching Slides)
Signs and Symptoms
Stasis dermatitis can begin so slowly that it is barely
noticeable or so rapidly that it seems to develop overnight. Signs
and symptoms include:
Swelling in one or both lower legs.
In severe cases, the swelling can include the foot and extend to
just beneath the knee.
Thin and inflamed skin
Itching (can be severe)
Open sores that can be painful and
Patches of skin can be dry and scaly
Reddish brown discoloration of the
Honey-colored crusting when the skin
Skin thickens and darkens with
repeated scratching and rubbing
Violet-colored lesions may appear on
lower legs and tops of the feet
As poor circulation leads to stasis
dermatitis, this type of dermatitis typically develops in people
who are middle-aged or older. In the United States, about 15 – 20
million people over 50 years of age have stasis dermatitis.
Rarely occurs before 40 years of age.
Females are slightly more likely than
males to develop the condition.
Poor circulation in the lower legs leads to stasis dermatitis.
One of the primary causes of poor circulation is advancing age. A
deep vein thrombosis, surgery, or injury that damages the veins in
the lower leg also can cause stasis dermatitis.
The risk of developing stasis dermatitis increases with
advancing age and the following:
Blood clot, including deep vein
High blood pressure
Heart condition, such as congestive
heart failure (a weakened heart cannot pump blood effectively)
People who develop stasis dermatitis
have an increased risk of developing other medical conditions,
including contact dermatitis (a common type of eczema) and
cellulitis (a skin infection that extends deeper than the surface
of the skin).
Stasis dermatitis often is a long-term condition that requires
care even when the skin clears.
Diagnosis begins with a complete medical history and visual
examination of the skin. The following tests may be ordered
because another skin condition can be present and effective
treatment includes improving the circulation in the lower legs:
Doppler testing to evaluate blood
flow to the legs
Patch testing to determine if the
patient has developed an allergy(ies) that causes the skin to
Biopsy of the affected skin
Getting signs and symptoms under control requires that the
patient follow a comprehensive treatment plan that may involve:
Elevating the legs above the
heart. When sitting and sleeping, this can improve circulation
in the legs and decrease swelling.
Wearing a compression stocking
while awake. Sometimes compression boots are prescribed. Both
the stockings and the boots can improve circulation.
Treating congestive heart failure.
Treatment may involve taking a low-dose diuretic to treat
congestive heart failure or high blood pressure.
Applying a low-dose topical
steroid. This can reduce inflammation.
Applying a topical antibiotic.
This is necessary if the skin becomes infected.
Avoiding scratching. This is
necessary to clear the skin.
Taking an oral antibiotic if
cellulitis develops. An oral antibiotic can help heal open
sores and prevent tissue damage.
Following wound-care instructions.
Getting the recommended bedrest.
Sometimes strict bedrest is necessary.
Once the signs and symptoms have
cleared, the patient may require lifelong preventive maintenance
Taking regular walks
Not standing for long periods
Elevating the legs when sitting or
Wearing compression stockings while
Moisturizing the legs regularly,
usually with petroleum jelly
Clark RAF et al. “The Other Eczemas.” In: Moschella SL et al.
Dermatology (third edition). WB Saunders Co.: Philadephia,
Flugman SL et al. “Stasis Dermatitis.” eMedicine. Last
updated September 2, 2005. Last accessed August 2006.
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developed by the American Academy of Dermatology
dermatitis comes on quickly, it can mean you have deep vein
thrombosis — a type of blood clot that can be lethal. Visit your
doctor or emergency room immediately.